• 대한한방내과학회지
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• 제38권3호
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• pp.392-400
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• 2017

Objective: To report the case of a patient suffering from cervical vertigo who was treated with a combination of Korean medicine treatments (including acupuncture, pharmaco-acupuncture, and Chuna manual therapy). Method: An outpatient with cervical vertigo was given a combination of Korean medicine treatments five times, from December 5 to 16, 2016. All of the treatments, acupuncture with electric stimulation and pharmaco-acupuncture, were applied on the trigger points (TP) of the cervical muscles and the upper trapezoid muscles. Chuna manual therapy was then applied on the cervical area. The Numeric Rating Scale (NRS) - according to outpatient's statement on vertigo, neck pain and headache - and the Korean Dizziness Handicap Inventory (DHI), which is a self-evaluating scale of dizziness in daily life, were used to evaluate the effects of this treatment. Results: At the end of the treatment, the vertigo and the headache disappeared. The NRS decreased from 9 to 0 for vertigo and from 5 to 0 for headache. Although the neck pain also decreased, it did not disappear; this NRS decreased from 7 to 1. The DHI score also decreased significantly, from 64 to 4. Conclusion: Since the symptoms of the patient with cervical vertigo improved after the very first treatment and the improvement of the symptoms was observed as the treatment progressed, this case report is worth supporting the efficacy of combined Korean medical treatments. However, because there was only one subject, it is hard to say that this efficacy can be generalized. Moreover, this report cannot prove the individual efficacy since various treatments were combined. While there are many researches related to cervical vertigo in Western medicine, the studies in Korean medicine are comparably insufficient; therefore, follow-up research on more subjects is needed.

• 대한통합의학회지
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• 제4권1호
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• pp.1-11
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• 2016

Purpose : The purpose of this study was to exam effects of aroma therapy on the woman with headache in range of motion, results based on Pain and the tiredness index. we applied this study in female patients with headache. tiredness, stress, pain to examine effects of easing off headache, Tiredness. Methods : The study has been conducted with three different groups of "H" University in Gwangyang, the forty-five 20's female university student with headache were randomly assigned to groups each groups did a survey to evaluate their tiredness, VAS, VRS before this study and after there are three groups: 15 people gets a swedish massage by using almond oil(I Group, n= 15), 15 people got a swedish massage by using lavender oil(II Group, n=15) and 15 people got a swedish massage by using lavender oil, smalled at the scent of lavender candle(III Group, n=15). I, II, III Group common characteristics(gender, age, height, weight) were measured by using goniometer to measured flexion extension, left right flexion, left right rotation of cervical range of motion. the measured data were analyzed by using repeated ANOVA. Especially in order to investigate the effect of Aroma therapy by using lavender candle this study is progressed 20 minutes, 3 times per week for a term of 3weeks(total 9). Results : The results of this study were as follows : 1) the VAS and VRS showed significant different result. 2) in the range of motion, cervical extension between Group I and II and left right flexion between Group I and III showed quite motional difference. 3) in the tiredness, there were no significant factors after examination. Conclusion : Therefore, the results of this study demonstration that the effect of Aroma therapy by using lavender candle didn't show prominent effects.

• Journal of Oral Medicine and Pain
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• 제45권4호
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• pp.97-109
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• 2020

Purpose: Cervicogenic headache (CGH) is pain referred to the head/ face from the structures in vicinity of upper cervical spinal nerves via trigeminocervical pathway. Ponticulus Posticus (PP) and Elongated Styloid Process (ESP) are anatomical structures that cause compression of vasculature present around upper cervical nerve plexus. Recently, computational fluid dynamics (CFD) has shown to play an essential role in identification of these high-pressure zones in the brain. The aim of this research is to study the association of ESP and PP in patients with CGH and to develop a hypothesis by CFD to analyse vertebrobasilar insufficiency as a contributing factor in occurrence of CGH. Methods: Retrospective analysis of 4500 full skull CBCT scans was done for the presence of partial or complete PP and length of Styloid Process (SP). Research was divided into two phases; In first Preliminary Phase, 150 scans that showed the presence of PP and ESP were analysed, and only 134 patients gave consent to fill the questionnaire containing 96 question items pertaining to symptoms associated with CGH. In the second phase, simulation of Vertebral and Carotid Artery was done using Fluent 14.5 Software and by CFD, pressure distribution on arteries was obtained that helped to identify high pressure regions. Results: Both PP and ESP showed a statistically significant association with CGH (p<0.001). By CFD analysis, both steady and transient phases of simulation showed drop in pressure due to constriction of internal carotid and vertebral artery by ESP and PP respectively and were found to decrease the volume of blood reaching the brain, 0.12 /0.13 mL and 0.06 mL respectively. Conclusions: Our analysis proves ESP and PP as contributing factors towards CGH. Hence for proper diagnosis and management of headache disorders, clinicians should have adequate knowledge about these anatomical structures and their resulting clinical symptoms.

• Journal of Korean Neurosurgical Society
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• 제58권1호
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• pp.89-92
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• 2015

Rheumatoid arthritis (RA) is a chronic inflammatory disease involving multiple joints. The cervical spine is often affected, and cases involving atlantoaxial joint can lead to instability. Anterior atlantoaxial subluxation in RA patients can lead to posterior neck pain or occipital headache because of compression of the C2 ganglion or nerve. Here, we report the successful treatment of a RA patient with occipital radiating headache using pulsed radiofrequency therapy at the C2 dorsal root ganglion.

• 대한정형도수물리치료학회지
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• 제18권2호
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• pp.87-93
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• 2012

Background: Headaches arising from cervical musculoskeletal disorders are common. Conservative therapies are recommended as the choice of first treatment. Evidence to the effects of manual therapy is inconclusive and available only during the short term. There is no evidence to exercise, and no study has investigated the effect of combined therapies for cervicogenic headache. Methods: In this study, 30 participants who met the diagnostic criteria for cervicogenic headache were randomized into two groups: experimental group and control group. The experimental group was performed myofascial release (MFR), Mulligan technique and self stretching exercises. The control group was performed electrical therapy and self stretching exercises. Assessments were performed to 30 participants before and after 4 weeks therapy. The components of assessments were headache intensity(HI), headcahe duration (HD), neck pain (NP) and neck disability index (NDI). Results: After 4 weeks therapy, HI, HD, neck pain and NDI were significantly reduced in both groups (p<.01). The HI, HD, neck pain and NDI were significantly reduced in experimental group more than in the control group (p<.01). Conclusions: Manual therapy could reduce the symptoms of cervicogenic headache.

• 대한통합의학회지
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• 제9권4호
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• pp.271-281
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• 2021

Purpose : This study aimed to apply muscle relaxation exercise and ultrasound therapy as an effective treatment method for tension headache patients by comparatively analyzing the muscle mechanical properties, neck disorder index, and headache impact test. Method : The subjects were classified into three groups based on the intervention received: the therapeutic ultrasound (n=15, group I), placebo therapeutic ultrasound combined with the suboccipital release (n=15, group II), and therapeutic ultrasound combined with suboccipital release (n=15, group III) groups. The intragroup and intergroup differences in muscle mechanical properties, neck disability index, and headache impact test were compared and analyzed. Result : The comparison and analyses of the changes in muscle tone and post hoc analysis revealed statistically significant intragroup decreases in the suboccipitalis and upper trapezius in groups I and III. Furthermore, statistically significant intergroup differences in the upper trapezius with a greater change in group III than in group II and suboccipitalis with greater changes in group III than in groups I and II were observed. The comparison and analyses of the changes in muscle stiffness and post hoc analysis revealed statistically significant intragroup decreases in the upper trapezius in group I and suboccipitalis in group III. Moreover, statistically significant intergroup differences in both muscles with greater changes in group III than in group II for both cases were observed. The comparison and analyses of the changes in the neck disability index and post hoc analysis revealed statistically significant intragroup decreases in all three groups and statistically significant intergroup differences with greater changes in group III than in groups I and II. The comparison and analyses of the changes in the headache impact test and post hoc analysis revealed statistically significant intragroup decreases in all three groups and a statistically significant intergroup difference with greater changes in group III than in groups I and II. Conclusion : The therapeutic ultrasound and suboccipital muscle release exercise effectively increased the flexibility of the muscles around the cervical vertebrae and reduced muscle tension and stiffness in tension-type headache patients.

• 대한약침학회지
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• 제12권2호
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• pp.41-50
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• 2009

Although Chronic tension-type headache(CTTH) is one of the most common symptom in primary headache, there is no definite mechanisms. But muscular factors and psychological factors is supposed to be related with CTTH according to many other studies and pressure pain threshold(PPT) is used to measure muscular factors. Methods 1. We performed this study with 63 patients fulfilling the International Headache Societ criteria for chronic tension-type headache and 20 healthy control group and measured the PPT of temporal muscle and trapezius muscle. 2. We investigated the correlation between clinical characteristic and PPT. 3. Each of the CTTH groups and Control group is divided to four group again - HNP, Spondylosis, Sprain, Normal according to Cervical spine X-ray. Results 1. The PPT of temporal muscle and trapezius muscle in the CTTH is significantly lower than that of Control. 2. In CTTH group, the PPT has significant positive relation with duration of headache and continued time of headache. And the PPT has significant inverse relation with Frequency of headache and Level of headache. 3. In CTTH group, spondylosis group has the highest PPT and normal group is second. And there are significant difference between spondylosis group and the others. Conclusion : We found that PPT is strongly significant to measure muscular factor in CTTH.

• 한국전자통신학회논문지
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• 제12권4호
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• pp.679-690
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• 2017

본 연구는 경부 전만이 감소된 성인을 대상으로 경부 자세에 따른 관절가동범위와 목 장애지수의 비교 및 상관관계를 알고자 하였다. 본 연구를 경부 전만이 감소된(Cobb's 각도 35도 이하) 젊은 성인 34명을 선별하였다. 평가자는 경부 관절가동범위 측정기구를 사용하여 모든 대상자의 굴곡, 신전, 좌측굴곡, 우측굴곡, 좌측회전, 우측회전, 전방 변위를 측정하였으며, 설문을 통하여 목 통증지수를 평가하였다. 모든 평가 후, 경부 전만이 감소된 대상자를 하위집단(전만의 심각한 감소)과 상위집단(전만의 경미한 감소)으로 나누어 관절가동범위와 목 통증지수를 비교하였다. 연구 결과, 하위집단은 상위집단과 비교하여 Cobb's 각도, 신전, 좌측굴곡, 우측굴곡, 좌측회전, 우측회전, 전방 변위에서 유의하게 더 높았으며(p<.05), 굴곡과 목 장애지수는 유의한 차이가 없었다(p>.05). 목 장애지수의 하위항목 비교에서 하위집단은 상위집단보다 통증, 들어올리기, 두통에서 유의하게 더 높았다(p<.05). 평가 간에 상관분석에서 Cobb's 각도는 굴곡, 신전, 좌측굴곡, 우측굴곡, 좌측회전, 우측회전과 유의한 양의 상관이 있었으며(p<.05), 전방 변위, 목 통증지수와 유의한 음의 상관이 있었다(p<.05). Cobb's 각도는 목 통증지수의 하위항목인 통증, 들어올리기, 두통과 유의한 음의 상관을 보였다(p<.05). 본 연구의 결과는 경부의 자세가 관절가동범위와 통증에 영향을 줄 수 있음을 시사한다.

• Journal of Korean Neurosurgical Society
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• 제57권5호
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• pp.376-378
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• 2015

Cervical epidural steroid injection is indicated for radicular symptoms with or without axial neck pain. Complications are rare but can be serious. Here, we report the case of a 54-year-old man with cervical radicular pain who was treated with cervical epidural steroid injection. Injection was administered twice under fluoroscopic guidance with the loss-of-resistance technique using air to confirm the epidural space. After the second procedure, the patient complained of severe persistent headache and was diagnosed with pneumocephalus on brain computed tomography. The patient returned home without any neurological complication, after a few days of conservative treatment. Though, a fluoroscopic guidance cervical epidural injection is also known to diminish the risk of complications. Physicians should always keep in mind that it does not guarantee safety, particularly in the cervical region, related to its anatomical considerations.

• 한국전문물리치료학회지
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• 제27권2호
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• pp.102-110
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• 2020

Background: There is an opinion that improper postures of the head and cervical spine are associated with temporomandibular joint (TMJ) disorders (TMDs). Objects: The aim of this study was to investigate the proportions among the cervical kyphotic angle, physical symptoms including the pain intensity level of the TMJ, and severity of TMD disability in patients diagnosed with TMD. Methods: Sixty-two subjects participated in the study. The evaluation tools included measurements of the cervical kyphotic angle based on the Ishihara index, pressure pain threshold (PPT) on the TMJ, maximal mouth opening (MMO) without pain, current pain intensity level of the TMJ measured using the Quadruple Visual Analogue Scale (QVAS), Korean TMD (KTMD) disability index, KTMD Symptom Frequency/Intensity Scales (SFS/SIS), and Korean Headache Impact Test-6. Correlation analysis was conducted to investigate the correlations between the cervical kyphotic angle and parameters related to TMJ symptoms. Results: Variables that were significantly correlated with the cervical kyphotic angle were the PPT around the TMJ (r = 0.259, p < 0.05), current pain intensity level of the TMJ based on the QVAS (r = -0.601, p< 0.01), and usual pain intensity level based on the SIS (r = -0.379, p < 0.01). The level of TMD functional disability was significantly correlated with the degree of headache (r = 0.551, p < 0.01), level of PPT of the TMJ (r = -0.383, p < 0.01), pain-free MMO (r = -0.515, p < 0.01), pain intensity level of the TMJ based on the QVAS (r = 0.393, p < 0.01), TMD symptom frequency (r = 0.739, p < 0.01), usual pain intensity of the TMJ (r = 0.624, p < 0.01), and most severe pain intensity of the TMJ (r = 0.757, p < 0.01). Conclusion: There is a positive correlation between the cervical kyphotic angle and PPT and a negative correlation between the current and usual pain intensity levels of the TMJ. The cervical kyphotic angle was a predictor of the pain level, tenderness threshold, and intensity of pain in the TMJ.